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Prescription savings coupon

BIN:

GRP:

PCN:

UID:

Pharmacist Instructions:
This discount is preactivated and entitles the member to all prescription benefits associated with this BIN, GRP and PCN codes (as per state and federal law). This coupon is not insurance.If you need help processing this prescription, call the pharmacist support line toll-free: 1-866-618-4723.

Customer Instructions:
To receive your savings, show this card to your pharmacist. For more information, call toll-free 1-866-618-4723.